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Sarcopenia, resistance training and your diabetes

Skeletal muscles use significant amounts of glucose. When muscles contract forcefully, glucose uptake increase by muscle fibers. About 80% of glucose uptake occurs in skeletal muscles among healthy people, while in people with prediabetes and T2D, only about 50% of glucose uptake occurs in skeletal muscles. Sarcopenia refers to the loss of muscle mass associated with aging. Skeletal muscle mass starts decreasing around the mid 40s range and the process speeding up after age 60 ranging from 3-8% every decade. There are physiological changes occurring as a person ages including sarcopenia that affect metabolism and insulin utilization and impact glucose control.

Resistance training can provide many benefits, including decrease in fat mass, blood pressure, and hemoglobin A1c; as well as increases in bone mineral density, lean muscle mass cardiovascular endurance, daily energy expenditure, glycemic control, insulin sensitivity and quality of life.

The increase in muscle mass (both type I and II muscle fibers) from resistance training is especially important for those with diabetes since it contributes to increased insulin sensitivity. Forceful contraction of muscle fibers with external load of weight or resistance increases GLUT4 protein content and the upregulation of insulin receptors so more glucose get into muscle cells. These benefits were demonstrated in the Health Professional Follow-up Study, in which adult subjects who performed resistance training for more than 150 min per week, had a 34% reduction in risk of T2D. In subjects who were obese and performed resistance training for at least 150 minutes per week or more, the risk reduction in developing T2D increased to 60%. Furthermore, in a meta-analysis it was found that A1c levels in those with T2D decreased by 0.67% as a result of a 12-week resistance training program compared to sedentary controls.

Resistance training is essential component in a structured exercise program to manage sarcopenia, preserve muscle mass and increase muscle strength in people with diabetes. Resistance training exercises should involve functional movements, multi joint and single joint exercises to improve activities of daily living and quality of life. Types of exercise include using resistance machines, free weights, and resistance bands as well as body weight. Initial training intensity should be moderate, which involves 10-15 repetitions to near fatigue per set. Eight to ten different exercises in a full range of motion, focusing on various parts of the body should be completed in 1-3 sets. Once the targeted number of repetitions can be consistently reached or even exceeded, then one progress to increase the resistance or weight/load on the muscle and decrease to 6-10 repetitions near fatigue to get bigger effect. It is recommended to perform resistance training 2-3 times per week on non-consecutive days to improve muscular endurance and strength. Further progression include increasing the sets as well as training frequency with a split muscle groups.

Contact me to schedule an appointment to work on managing sarcopenia, muscle mass and improve your glucose control.


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